Pre-Columbian leprosy

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E-COLUMBIAN LEPRfi

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PRE-COLUMBIAN LEPROSY.

BY ALBERT S. ASHM EAD, M.D.

Dr. Muniz, of Lima, Peru, alone of all the aathor-
itiea known to me, thinks that leprosy did exiet
among the Incas ; he finds evidences of this in some
ceramics, the kuacos.

In the AmeTican Anthropologic for Jjinuary, there
is an article entitled " The Huacoa of Chira Valley,
Peru," by Samuel Mathewaon Scott. This valley
was once teeming with population, though scarcely
populated now. In this partof thecountry, there are
numerous ruins and gravea, and Mr. Scott's excava-
tions among these monnmenta of the past, enabled
him to make a collect ion of Peruvian antiquities, now
in the Museum of the Univeraity of Pennsylvania
at Philadelphia. All the pottery found in those
buriil grounds are called huacos. They are found
by the side of the mummiea. "About the beads
of the mummiea, whether male or female, were
ranged the pieces of pottery in black and red clay
which are known as huacos. These were probably
filled with water or chicha — a beer made from corn,
the beverage of ancient Peru, Upon these jara the
artists expended all their akill. The clay itself ia
very finely worked; the deaigna are infinite in variety
and imitate every form of animal and vegetable life.
There are Jars in the shape of bananas, gourds and
melons; there are jars ornamented with human fig-
ures, climbing monkeys, pelicars, parrots, fish and
Berpents. Thel'e ia, moreover, a diatinct tendency
toward the comic and grotesque — many animals have
exa^erated teeth, and birds have quaintly elongated

. , It is on these vapee that Dr, Muniz claims to have
'./cSjn^'figliEeftSs^Jicji can raftscuiabjy, if they muat not
•ab'sbfuCety: W fesplaijietit' iliy'-.thfi intention of the
artiste to represent leprona effects.

Dr. Brinton, of Philadelphia, kindly invited me to
examine the Peruvian antiquities in the Museum of
the University of Pennsylvania. Under these antiq-
uities can only he understood : 1, hands and feet of
mummies; 2, the huacos. For skulls are out of the
question. "A leprous cranium," writes Hansen,
"shows nothing peculiar, as the skull is never affecied
by leprosy." For the purpose of comparison with
\' hands and feel, Hauseu sent me photo-

graphs. (He writes: "You can see the oasa me-
tacarpi, especially the first and the fourth, atro-
phied, and also the distal phalanges; the curvatures
of the fingers are to be seen too,") of a leper's right
hand in two attitudes, from Dr. Kaurin's collection of
leprous preparations at Reknas leper hospital, Molds,
Norway. It belonged to an anesthetic leper.

There is a large collection of huacos pottery in
the Museum of Archieology of the University of Penn-
sylvania. I examined it with Mr. Stewart Culin, the
director. In none of the apecimena was there any
representation of face, hand or foot which could in

any way be supposed to be indicative of leprosy, I
also examined with Mr. Coliu, mound- builders pot-
tery 'from the stone graves of mound-buildera in
MisBouri, According to Mr. Culin's opinion, these
epecimens are unquestionably anterior to the Con-
quest. In them the following evolution is shown :
First, there appears the simple form in clay of a
gourd.^ Next, the gourd changea to the representa-
tion of the pregnant form of a woman, witli the face
of the woman on top. Thus the vase, which had be-
gun with the original gourd, had become in course of
evolution, a human form. Gradually this torso as-
sumed hands, feet, backbone and buttocks. A simi-
lar evolution in ceramics, from the gourd to human
forms, occurs in East Asia. I think I may make
here an observation which will be superfluous for
moat readera, but which perhaps, will strike aome as
interesting. The gourd is the original vase of these
nations. Naturally, when the artistic genius arose in
their descendants, vases were made from clay, in the
form of gourds. The idea of vegetable life, exiating
in the gourd, extended to the vase and developed
finally into conceptions of animal life ; thus was sug-
gested the pregnant woman with the swelling belly, in
a sitting posture. When the human representation
had appeared it did not long remain limited to this
feminine image; the male also was delineated. The
development of the human being originating in the
woman's womb, was shown in pottery through all its
grUdatious: development of the face, then face and
flhoulders, then vaaes with face, shoulders and handa ;
feet succeeded, then all these parts with backbone
added, developing through the clay; finally came the
buttocks. In this way, the vase was endowed with
life and became a household idol. The vase living,
in the fancy of the people, was aupposed to have ita
eyes on the affaira of the household; if they had

mound-buildarB modali.

^: i

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CM Ia J

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Lepra Aaesthelicn. The right hniid In two Bttiludea. From Dr.
arlBOn with bonsa ol l"ernvliin muminlea.

I

» ^^B

Cinade up their mindB to commit a sin they took care to
turn the face of the earthern god to the wall. The
mooDd builders, in order to leave nothing to chance,
made their household gods with blind eyea; this at
least is what the examination of these remains leads
us to suppose. There are other vases in which the
pennies, as we may call them, have sealed lips, to
prevent indiBcretions. These blind eyes or sealed lipe
are the on!y deviations from the usual and healthy
course of nature that I, at least, could discover in
these monuments of prehistoric times.

The same evolution from the gourd to perfect hu-
man forms is found, as I said before, in East Asia.
There leprosy is acknowledged to have existed for
many centuries. Yet in the East Asiatic ceramics
not tlie least trace of any intention to represent de-
formations can be found. It is true that I have seen
some deformations in the American Museum of
Natural History, New York, but they certainly, what-
ever they are, are not leprosy; they may be due
to syphilis, a disease which we know to have existed
in Peru; syphilis and leprosy both would destroy
the structures of the nose, and destroying the nose,
would spare the upper lip. Now the deformations
represented by these works of art show this: in
three instances the cartilaginous part of the nose
and the upper lip removed as by a knife, showing
the septum and nasal bones and the soft tissues cov-
ering those remaining, and also the teeth; one figure
lying prone upon the belly, with both feet gone to
above the ankles. The nose and upper lip partly
cut off, but both hands are perfect. Another figure
shows a partial loss of the upper lip, a semi-circular
piece being cut out on the left side, teeth showing
where the lip should have concealed them. This
head is drawn far back — opisthotonus. Another one
has the uose cut off, with the septum showing, and
chin considerably drawn forward, a perfect mouth
being at the top of it. Another figure shows a chin
drawn strongly over to the right side with loss of

upper lip. Id all these figures the hands are perfect.

I regret not to be able to give photographs; but
the explorer. Mr. Bandelier, the owner of these speci-
meDB, who is at this moment excavating in Peru, ex-
acted before his departure, the promise that these
articles should not be represented before he had fin-
ished his research. I asked the director, Mr. Saville,
whether he thought, from his own investigations in
Yucatan, Mexico and Peru that these peoples would
make representations of loathsome diseases on their
pottery. He saya that he has seen the coitus^ repre-
sented in that pottery, and also some orgies, and that
this disposed him to think thatothermatters might be
represented which, in our own ideas, do not belong to
art. He called my attention to a publication in the
Scientific American in 1884, from Dr. Le Plongeon's
diacoveriea in the ruined cities of Yucatan: "The
figure (stone) was found on its back; one leg was
broken off below the knee, but was found under the
figure and afterward adjusted. The head of the statue
rested on a stone painted red, that represented
the tongue of a serpent, the peculiar shape of which
Dr. Le Plongeon long ago di&covered to be the letter
chi or ch of the Maya alphabet.

When the figure was placed upright we hardly knew
what to call it, it appears so human, yet so apish.
In the position it occupies it is 97 centimeters (about
three feet) high. So if standing it would not repre-
sent a very tall person. It is made of white limestone
and painted dark brown. The head is flat at the top
and back, and apparently hairless, but painted blue,
and over that are red streaks from the forehead down
to the ehoulders. The eyes are open, and painted
bine around the lids. The noae is not pierced, but
the clumsily made ears have each a large hole. The
mouth is closed and lips painted red. On the back
part of the top of the head a hole is pierced, so that
a string can be passed through, perhaps to secure a

1 to be mittens, the other ends of which are no-
■ where visible. The fingers, like the toes, were fur-
nished with nails made of shell, and fitted in place
with mortar ao as to look very natural even in color.
Unhappily nearly all were fallen, but we found some
of them. A necklace is indicated by a line of red
paint around the throat. Garters, below the knee,
are painted blue and red. The loins are covered with
an ornamental tint, a scanty garment yet in use
mong the aborigines, and anciently worn by Egyp-
an laborers. The right foot is turned in, as if the
iidividual had been club-footed. The sandals are
minted blue, and close up around the heel, but
he very elaborate and fanciful fastenings are red.
On one heel is the name, Caij Canchi, written with
Bed paint. " This image," says Dr. Le Plongeon, "may
sibly represent the sacred menkey of the Mayas,
&8 the Cynocephalun was emblematic of the god Tfioth
■among the Egyptians.-'

A monkey, even a deformed one, was thought wor-
thy to be represented in stone, Mr. Saville suggested
that it might be, not a monkey, but a leper, as the
arms were cramped and the hands were in a clawed
position, similar in some degree to that of a leper'a
hands {not mutilated).

Dr. Emil Holub, an African explorer who was pres-
ent at the Museum, told Mr. Saville that he has seen
lips cut, as in these huacos, and something ornamental
placed in the openingB, in African Bushmen.

I may say that it would hardly be natural that art
should represent loathsome features of nature, which
could not be looked at without pain and perhaps hor-
rible recollections. It was the idea of a correct human
development that was in the mind of the potter, and
Lvfhat had the horrors of an awful disease to do with
Ithat?

B clear that the non-existence of any leprous
RcharacteristicB in American antiquities is not a proof
Bthat the disease did not exist in this country anterior
I to the Conquest. The thing is simply this — non liquet.

10

Through the courtesy of Dr. Brinton and Mr. CuUiif 1
I have been permitted to examine closely the follow-y
iug Peruvian remairiB in the collections at the Mu-
seum of Archeology, University of Pennsylvania:

1. The Scott collection, from Chiras Valley, Peru, 1
to which reference has been made in the article |
published in the American Anthropologist for Janu-
ary: bands and feet of several mummies; post-

Columbian, as shown by the presence of glass beadaj

2. Dr. Carl Lumholtz' collection, from Chibuahuai
Mexico: cave mummies' handa and feet, presumably;
ante-Co!umbian remains from'burial caves (a verj
ancieutform of disposing of the dead) ; North AmerJ
lean Indian remains, presumably prehistoric, certain! jj
several hundred years old; cave mummies' hands andS
feet from Nararachic, Mexico; remains from Saq

11

I

Mateo. Peru, near Ancon, the most aocient buria!
place in Peru.

3. A lacquered miimniy head from Ancon, Peru,
with gold band over the mouth, presumably of a
priest or sacred person carried over the country for
worship according to custom.

A coilectioD of loose bones of hands and feet
from Cave Valley, Mexico (cave burial).

5. Apache bones, hands and feet, from Sonora, Mex-
0. (Apaches are thought by some observers to have

East Asiatic (Tartar) characteristics and customs.)

6. Remains from a cave near Yoqinbo, Chihuahua,
Mexico, not ante-Columbian, on account of presence
of glass beads.

7. A collection of perforated human bones, mostly
humeri, from the mounds of Ohio. These perfora-
tions in the olecranon fossa were formerly supposed
to be syphilitic ; but they really are accounted for by
the forcible extension of the arm, necessitated by the
grinding of corn. In none of these bones was there
any evidence of leprosy,

I examined besides, skulls from Choptauk ossuary,
the sand bonepits of Dorchester County, Maryland,
remains of Nanticoke Indians ; nineteeii casta of the
Maniz collection of Peruvian skulls, showing ancient
trephining, recently exhibited in the Smithsonian
Institution, Washington; and sknlls of Indians, ex-
cavated in Florida, These last are the only ones in
which there can be perceived any evidence of disease;
probably syphilitic osteitis, through intercourse with
Spaniards.

There is a diseased skull in the American Mu-
seum of Natural History, New York, from an ancient
grave at Lachay, near Chancaz, Peru. It belongs to
"le famous Bandelier collection. On the left side of

KOTB.—Brlnton Bays; "£□( nn obscQilly certsiuly haa^ over Che
•thnogrepliy of Florlim at tbe ^lerlDd of Ibe rllacovcry. A Inrge part af
fiw penlnaola was peopled by a tribe whose langnage stood bIdob on
the aomlaeiit, the TlmuFUHS. aod whlati became extlucl generallODs ago.
TbeToredeHcrlbed bf the Spanish end French explorers of thesliteenth
century, as quite n calturedpeorl-e sod at that time as balldlug mounds
■ndetectluR thelrbouAes upouchein."

12

the frontal bone, near the median line, there is an
egg-ahaped, deep cavity, which doea not peuetrate the
internal table of bone. This cavity has the appear-
ance of having contained a hard smooth subetance,
probably a bone cyst, and the bone seems to have
grown partly over the foreign body. Upon the parietal
and occipital booee and especially on the frontal bone
between the cavity and the orbit, ate evidences of
Buch destruction as might result from syphilitic
osteitis. These evidences of disease, excepting the
cavity in the frontal bone which, I may say ia
passing, has nothing to do with leprosy, are aimilar
to those found in the Florida Indiana. The latter
evidently had contra-cted syphilis through their
connection with the Spaniards of Mexico.

Mr. Culin informs me that there is one distinctly
connecting link between the Mexican Aztecs and the
AsiaJiicH, besides that evolution of pottery which I
have described above. It is the game of patoli. Thia
game is played in Mexico thus: there is one stave
held with the hand, across three parallel staves
is used as a bat to throw beans or balls up to be
caught, when falling back, upon a cloth; a tally ie
kept, according to the position in which these baits
fall on the cloth. The three parallel staves are
marked with an arrow, the single stave which croaseg
the parallel onea has the mark of a bow on it. The
game was originally played not with staves, bnt with
arrows, the warrior always holding three arrows with
his bow. This explains the mark of the arrow on
the staves. That the same game, absolutely the sa
should exist in Asia can not be due to chance.

It seems to me that the intercourse, whatever it
may have been, to whatever degree it may have ex-
isted, between America and Asia is the only thing
which could, after what I have said before, make '
admissible that leprosy existed here before Columbus
came. Certainly syphilis existed here, and, if
did, it could not have come from anywhere else but
Asia. Therefore, in spite of the absence of every.

13

[proof of the preseuce of leprosy here, before the Con-
quest, we must consider the question as still in doubt.

The oldest center of leprosy in America, ia Old Col-
ombia, (Granada, Venezuela and Ecuador.) Cartha-
gena of the Indies was a most ancient focus of leprosy.
Mr. Luther F. McKinney, U. S. Minister to Bogota
says; "This country is cursed with leprosy, there
being about 24,000 lepers in Colombia alone. Unless
something ia done to isolate those who are afflicted,
and means taken to prevent the marriage of lepers,
the whole country will eventually become a race of
lepers."

The librarians of the National and the University
Libraries of Ecuador, can find nothing for me, in
any way connected with the origin and history of
leprosy in Spanish America. These libraries are
lamentably small and imperfect.

I am informed by the British Minister in the same
country that all matters relating to leprosy have been
extensively treated in Colombia where as I mentioned
above, the disease is very widely spread. In Ecuador,
he saya the number of cases is comparatively small.

Dr. Zeballos, the Argentine Minister in Washing-
ton, writes that although he is a student of South
American history he does not remember having read
that leprosy existed among the Indians of his coun-
try previous to the advent of the Spaniards.

Dr. Juliano Moreira, physician to the Hospital
Santa Isabel, Bahia, Brazil, says that the natives
there before the Portuguese colonization, the Tupis,
the Krars (Keras), the Goytacazea, the Guerens, the
Gucks, the Parecos, the Gaaycurus, the Lengoas and
the Aruwacks, were certainly not leprous and it ia
incontestable, in his opinion, that among the Indians
now living, there is no disease that can be construed
into leprosy.

Dr. Bibb, of Saltillo, Mexico, says that among the
most prominent and best informed men in the city
of Mexico, the general opinion ia that the diseaae was
introduced there by Chinese.

14

Dr. J. B. Torres, Vice Coiisul-General to Hayti_
thiDke that nothing has been written by any native
of that island, nor by any foreigner, either as to the
origin and history of leprosy there. However, it la
supposed by o!d physicians, with whom the Vice-
Consul apoke on the subject, that it was introduced
by the Spaniards ; but there is no proof of that. The
eame geutleman states that leprosy ia very rampant
in that island, and that uo precaution whatever is
taken to isolate the cases. There is no leper hospital,
and the lepers are allowed to circulate without let or
hindrance.

Dr. Beaven Rake (Report on Leprosy, Trinidad
Leper Asylum, 1890) quotes from Leloir, page 300,
that Dra. Magalhoea and Mayriuch state that before
the discovery of Brazil there was no leprosy amoof
the Indians, nor subsequently in those who did no'
mix with the foreigners.

Beaven Rake says that of 216 lepere treated in the
asylum, 74 or rather more thao one-third were coolies.
Of 138 reported from outside, oniy 29 were Hindus.
No doubt there are more, for coolies when free do
not seek medical advice so readily as other patients,
unleaa they are paupers and wish to be maintaiuer
in the colonial hospital or leper asylum. "On the'
whole, then," says Rake; "the proportion of cooli'
lepers may be fairly taken as one-third. The ques-
tion is. Where do they get the disease? We are told
that there are some 250,000 lepera in India, and it is
therefore hardly fair to suppose that all the Hindus
who develop leprosy in Trinidad become infected
here. It is far more likely that in some or many of
them, the disease is already incubating when they
]and here, though it may not be evident enough t(
insure rejectiou after medical examination."

I have received a letter from Mr. McKinney, U. S,
Minister to Colombia from which I extract the fol-
lowing;

Bie coa.at witb a large bod; oF men to explore the interior,
e discovered the beautiful plain ill which Bogota is situ-
ated, and founded the city of Bogota August 6, 1538. Some
time after this, I do not know liow mauj years, he was at-
tacked witli leprosy and died of it, 1 think about 1578. This
was the firet case known in Colombia, and attacked the first
Spaniard who entered the country. In a late converBation
with the acting Minister of Foreign Affairs, an intelligent
gentleman, he said : ' Leprosy was not brought here by the
Spaniards, but was developed here by the mixture of the
races.' I can not see, however, that this can be true when
the first Spaniard who landed in this country, contracted the
disease and died of it. It seems very plain to me that this
man had the disease in his blood, and it developed itself
here. It is a well-known fact that leprosy had long before
this existed in Spain, thoueh at that time it is said to have
been extinct. But while tne disease is hereditary, it some-
times skips a generation, and thiB man may not have known
his blood was tainted with the disease. This is the first liis-
torj of leprosy in Coiombia. "About 1550 a priest was sent
by this same man to Africa, and be brought ceKroes to Fana-
d that was the first introduction of the black race into

Coloi

(Si

Lote.)

" But from all the facts I have been able to gather, the lep-
rosy can not be attributed to tlie negroea. There is very lit-
tle pure blood of an; race in Colombia ; the people are a mix-
ture of the Spaniard, Indian an d negro races. Whether this
mixture of the races, as some here assert, has caused the
rapid spread of the disease, I am not competent to judge.
There are in Colombia now, from 25,000 to 30,000 lepers ; some
put it at 60,000, but the weight of authority is in favor of the
former numbers. The doctors here in Bogota declare uni-
versally, as far as I have talked with them, that leprosy is
not contagious except by inoculation and heredity. But
there are differences of opiniaa about this, and you are bet-
ter able from your study of the subject to ans\vec' Chat ques-
tion. Considering the large number of lepers in Colombia,
the trade carried on with the United States, and the large
number of Americans who are constantly coming here and
returning to the United States, this is a matter of great
importance to us, as it is likely in time to be carried to our
country, especially as there is every year more or less mar-
riage between the people of the two countries.

"I think one cause of the fearful spread of the disease is
the poverty and filth of the people. Bathing ia considered

NotE.— The first ueitro ia Peru waa wllh "ihe IhlrtBen" ol Iba Isle de
" " ' ' ■■ - - ■ ■■ ■ - ■ eaida'siimel

here more deadly than leprosy among the common people, '
and auy filthy disease would find a congenial home amons
them. Another cauEe Qia; be that the people are curaea
with syphilis which was first brought among this people by
the Holdiera from Venezuela, during the early wara of inde-
pendence. However, some Bay that thoae who have the one
disease, are not so apt to take the other.' The eovernment
has BO little money to expend for the purpose, that th
little done to isolate the disease, and though there are many
Bchemes, and some hospitals for these unfortunates, they '
are scattered over every part of the country, and because of ,
the laxity of sanitary regulations, they become beggars and
vagabonds everywhere. X see them every day on the streets
of this city. Unless something is done soon, the nation vrill
become a nation of lepers and a menace to every civilized
country. , . .

"In my opinion the day will come when leprosy wil
mand tne attention of the medical profession of America,
far more than it ever has in the past. May the day be far
distant when our fair land will be cursed by such a loath-
some disease."

Dr. Manuel A. Muniz, of Lima, Peru, in the Cronica j
Medica of 1886, contributes an article entitled, '
' Lepra en el Peru." His notea were taken from the
Historical Discourse on the Fouadation and Rights
of the Hospital San Lazaro, Lima, by Bravo de
Lagunae, published in Lima, 1761. This work ia in
the library of Santiago de Chile. Dr. Lagunas shoves
the first royal ordinance for the care of lepers and
for the foundation of a hospital was made in the time
of Charles III. In 1693, the alms were ordered to b
used for the support of a hospital for Indians.
Finally, Philip II. prescribes that such aick persooB
as are afHieted with contagious diseases be carried to
elevated localities, from which no defiled wind having i
passed the hospitals, can flow dowu and reach the .
healthy population of the lowlands.

Dr. Muniz mentions the first leper hospital at Lima, J
built by Anton Sanchez, a citizen of that plat
1563. In 1606, according to the same authority, Lima |
was full of lepers, and those unfortunate persona ]
were too much for San Lazaro ; they were admitted J
elsewhere, and many of them died unknow n and 1

17

rm "

without aseietance, even without the sacrament.
Fear was exprsBBeil lest the infection should
spread over thti whole country, and the auc-
ceesora of Sanchez took care that all lepers should
he received in their enlarged hospitals, which coa-
eiated of three houses; one for men, one for women,
one for uegroes. All lepers to be received, unless
they were slaves. As to the latter, their master was
bound to take care of them during the first year. It
is said that these masters need to evade this obliga-
tion, by antedating the outbreak of the disease.
These buildings are to-day tenement houses, having
outlived the terrible scourge against which they had
been huilt. In 1639, the chronicler Cobo mentions
the hospital San Lazaro, slightingly, saying that it
was very poor, and little resorted to, which proves
,tiiat the disease had already broken its wings. Bravo
"le Lagunaa corrects the error of Echave, who states
lliat San Lazaro was founded for negroes : "All free
persons, suffering from San Lazaro'a evil, whatever
their social position, condition, sex or age, are re-
ceived in it;" which shows, according to fir. Muniz,
how ill informed was the author of the book, entitled
the " Star of Lima," (or Description Sacro-political
of the Beauties of the City of Lima, published at ,
Amberes in 1688), when he said that the hospital of
San Lazaro was built for aegroes, and also Melandez,
who says that, failing patients of that color, the
hospital would have been empty, if it had not been
made into a common aick-house for the falling evil,
lause the south wind with the cold dryness of the
ides, loses its poisonous qualities, and rather sub-
168 than corrupts the humors. Bravo de Lagunas
_iTea a number of reasons, and quotes authorities to
invalidate this testimony. From 1700 till October
1746, this leper hospital was financially successful.
Then came the earthquake which destroyed Callao,
and partly Lima, and not one atone of the leper hos-
pital was left standing upon another. For over six
years the lepers had to live in ill-made cabins or

18

miserable huts. In 1758 the new leper hospital was
inaugurated ; the money for this purpose had been
obtained by lottery. In 1822 the hospital of incura-
bles and that of lepers, were made one. The old
leper asylum was converted into a school, and after-
ward into barracks.

Lagunas tells us that physicians generally assume
as a cause of leprosy in those countries, contrary hu-
mors which destroy the skin, and are much fostered
by bad food, depraved constitution, hot air, unclean-
ne^s, slovenliness in places of habitation. '^Others
who believe in the vermicular system, see the
cause of cutaneous diseases and pestilences in small
insects, imperceptible gnats which penetrate into the
body through the skin, assign this same cause to lep-
rosy. These animalcules stick to the garments, walls
and even stones. In this manner, they account for
its contagious nature, the insects ot seeds pass into
other bodies from the air, or by contact with those
parts to which they are attached." Here we have
then, the embryo of bacteriology in 1761 !

I quote further from Lagunas: "A doctrine in
which all eminent physicians agree, and which is also
favored by the priests, is that scabies, psora and lep-
rosy only differ in degree. Scabies consists in small
pustules which disfigure the skin. In psora, a per-
nicious itch is added, and if these symptoms are
aggravated or extend to the internal parts we have
leprosy." Muniz says, however, that they carefully
differentiated leprosy and the gallico.

An early law in Lima prescribed that parties of
Tecently introduced negroes should be stopped at a
•distance of at least one league, before entering the
»city, and should remain in quarantine until the
chapter had satisfied themselves that they were free
from contagious diseases ; and the city went to the
trouble of building houses in the suburbs, on the
banks of the river, where the quarantined people
could temporarily stay, till they were sold and spread
over the country. "It was the same theory of conta-

19

gion," saya Muniz, "which obliged all lepers to use no
speech in askiug alms, but to niiike use of belle and
wooden timbrels." Evidently the negroes were aiia-
pected as a leper importing element.

Id the middle of the last century, the leprosy of an
illustrious prebendary of the Cathedral of Lima
caused a famous litigation.

In i,7Cl, Lagunas says, that "it has been observed
in the hospital of San Lazaro, in Lima, that as far
back as memory reaches, four persons have been in
immediate attendance upon the patients, and never
did any of them catch the disease. In this hospital
there is now a young woman with furfuraceous lep-
rosy, two patients covered with piirulent tumors and
who scarcely present human shape, and several
others just as wretched, though with smaller deform-
ity. There are others with feet and legs fail of scabs,
and almost as thick as the body, who in every other
respect seem to be well, and have done for many
years such services as they were able to perform.
There are some whosearticulatious have given way, or
whose tingera have fallen off, and there is another
whose foot detached itself altogether, and who walks
and stumps along like a trunk. There is a leper whose
voice is ao raucous, that it reminds you of the snarl-
ing of a dog, or of some other moaning animal."

Muniz quotes from Parra, "a Colombian physician,
as unfortunate aa he was intelligent," who suffered
from the terrible effect of the disease, and described
in eloquent and graphical pages its pains, its tor-
ments — (Ricardo Parra, of Bogota, Colombia; his
work was entitled "La Lepra," and was published in
1850-1860) : " The first notable Spaniard who caught
leprosy, was one of the conquerors, Gonzalo Jimenes
de Quesada; he died of it. There ia no doubt that
he contracted the disease through contagion, and
that therefore leprosy must have been here before the
Conquest. In America its resort of predilection was
ancient Colombia ; it never gained much of a foothold
in Peru."

20

I shall quote Parra at some length to give a clear
idea of his etiologic theory: "Elephantiasis is a rad-
ical and constitutional asthenia, which tends toward
partial gangrene. It is not only a nervous asthenia ;
it is asthenia of all the elements, organs and func-
tions.'' Parra nearly forty years ago had an intuition
of the microbe. " I shall show," says he, how an
impression, whatever its origin, whether from cosmos
or microcosmos, from the external world or from the
organism itself ; how such an impression working on
a sensitive nerve interferes fatally with a nervous
center ; how this nervous center by means of an exo-
dic fiber and of a special nerve apparatus, the vaso-
motors, acts upon the vascular system, contractible
in all its extent ; how this reflex action hurts and
disturbs that system, causing a beginning of paraly-
sis of atonia and weakness in the play of its power
of contraction ; how these vessels ceasing to act
normally, interfere with the blood circulation,
and every kind of circulation; how the impedi-
ment in the way of the general circulation, check-
ing the free exchange between blood and tissues,
and the free contact between the tissues, and all the
fluids and humors of the economy, produces princi-
pally three things : anemia and asthenia of the nerv-
ous centers, anemia and mortification of the tissues,
alteration of the composition and even constitution
of the blood, and perversion and depravation of all
the humors, liquid products, and all the secretions
of the organs ; how these causes interfere with all the
functions of nutrition ; how this disease of nutrition
in all its functions aggravates and increases the cen-
tral enervation ; how this enervation, already deep-
seated, and the perturbations of nutrition, produce
general dyscrasia of the humors ; and how all these
causes together, working and acting, one upon the
other, being at the same time causes and effects, en-
gender and produce thausands of abnormal phenom-
ena, which, united with them, in masses, every day
increasing with growing and irresistible action, pro-

jeseively progressive mortification, bIow dis-
iganization, increasiDg paralysis, aud lead finally
to extensive phagedena and general gangrene."

Here is another quotation from Parra: "The
wrinkles, fissures and scabrositieB, the fall of the hair,
the deequamatioD, the general debility, the couaump-
tion of the muscle between the index and the thumb,
the cold, the atrophy of various parts, but especially
that of the vertebral column, must be the immediate
effects of the disturbance of nutrition in all its func,
tioDB, interfered with by the constriction of the ter-
minal extremity of the arteries and capillaries. The
turgid countenance, the livid, bluish, ashy or purple
color of the face in one form of the disease, and the
discoloration of the scalp, the formication and numb-
ness, which are symptoms of myelitis, in the other
form ; the feeble pulse, slow and heavy, which seems
to beat through mud ; the inflated, very voluminous "
veins — all these symptoms of either form must be the
natural result of the disturbance of circulation, com-
bined with the disturbance of hematosis and nutri-
tion, cyanosis, black blood, fluid and fibrinlesa, bluish
veins under the tongue, a thick and infiltrated skin,
infiltrations of the cellular tissue, edema in various
parts, infiltration of the corion, glandular inflation,
diseased condition of all the glaudulst, disorders of
menstruation, epiataxis, at times frequent, affection
of all the mucous membranes, are in tuberculous
lepra the result of the combinations of the lesions of
blood circulation; aud all kinds of circulation, of
respiration, hematosis and nutrition. And the nu-
trition perverted and working with a damaged and
atonic circulation and corrupt sanguinifi cation,
added to cyanosis and swelling of the face and other
parts, and to the capricious changes of color, will give
ns the swelling of the lingual veins, the miliary gran-
ulations, the spots, the warts, the tubercles and a
thousand other morbid products; and finally the
Bimultaneous affection of th«se three functions, added
to the lesions of sensibility and motility ...

22

will give us in combination, the curvature of the fin-
gers, the disarticulations, the muscular debility, the
numbness, the lancinating pains, the vague pains,
arthritic, vertebral, and finally, the osteocopic pains,
and all the pains in their terrible reality ; they will
give us the vacillating gait, the contracted hand, the
crook- legged walking, the spinal curvature ; and in
another combination they will give us the jumentous
urine, the cottonous skin, the forehead bacon-rubbed,
exaggerated or malodorous sweat, and the absolute
cessation of transpiration, the abscesses and furun-
cles, the spots of all size by vascular relaxation, the
knots and horny spots, the tubercles and ulcers ; and
in another combination of the same form, all these
functions (danadas), will give us dyspnea and suffoca-
tion, palpitations of the heart, the constriction as
with a girdle, the precordial oppression, terrible
nightmares, satyriasis, and violent hunger, the thirst
and the hydrophobia, the blindness and the photo-
phobia, the libido-inexplebilis, and the motiveless
rage, the general despondency and unspeakable tor-
ment. And all this in consequence of primitive lesions
of the circulation and innervation. All this in conse-
quence of the loss of vital energy effected (herida) in
the nerves, and effected in the blood, effected through
the want of oxygen and effected through the want of
nervous influx."

I shall give also Parra's description of a leper hos-
pital ; it will show the character of leprosy in ancient
Peru and Colombia, and the mutilations which
Muniz seems to find represented in the huacos pottery :

. . . " in some, the muscles have become pale,
weak and are slowly destroyed ; in those who follow,
the articulations are scooped and excavated, in an-
other the articulation of a foot is detaching itself,
in the next the hand is already detached . . .
one entirely shorn of muscles and arms, has nothing
left but a putrid trunk; but death disdains the
mutilated trunk, and these wretches just as they are,
feed with voracity, digest well, rave and blaspheme,

23

md burning with lascivious fury, get libidinously

drnnk, and revel in shameful dreams and filthy fao-
cieB. . . . Look, finally, at that hundred of mon-
strous beings, mixed up together, piled up oiie on
top of the other, and wallowing in the duet. Many
have no noses, nor lips, nor ears, nor hair; where
the fafle used to be you see now three or four holes.
. . , The amygdals have fallen, and they can no
longer croak; their noaes are stopped and they can
no longer breathe through them; larynx, pharynx,
esophagus have been devoured, and they can not
swallow ; some are mad with hunger, others devoured
by unquenchable thirst. Here are some in whom the
raucous roar of the lion has turned to Catilioarian
voice and perfect aphonia. In another subject the
lungs charged with purulent foci can hardly expand,
and here is another whose heart has almost stopped
beating. Some weep, others curse, others blaspheme.
Others, pusillanimous and craven, tremble and cry for
mercy at the least provocation ; others laugh danger
to scorn, and careless whatever may happen to them,
die with stoical indifference. Unceasingly flowing
tears and a viscous glutinous humor keeps their red
and inflamed eyelids apart, so that many He blind or
grope blindly in the darkness. Many of them have
frightful dreams and awake roaring like lions or howl-
ing like wolves. The urine of all these men is thick
( jumentous) like that of the horse, or clear and raw, as
if passed through a filthy filter ; there are no sewers
moremephitic thau their defecations. Some of them
lie motionless and entirely paralyzed, and as, at the
same time they can neither articulate uor swallow,
they are dying of hunger and parched with thirst, not
being able to ask for help. All secrete a fetid sanies
over the whole body, and breathe an air which they
themselves have poisoned. . . . A horrible caries
consumes all the articulations and causes the sever-
ance of the limbs, which fall off by pieces, the pha-
langes of the fingers are shaken off and the teeth
break forth from their sockets. . . . Some of

24

these trunks talk ; demented, mad, they try to sing
in their delirium, and their voice is now like the
hissing of a snake, and now like the cavernous
echo of a tomb. Look, now, at that horrible scene ;
some of these trunks, formerly men, now masses of
rotten flesh, are possessed by libido- inexplebilis, and
would like to indulge in pederasty and onanism with
other not mutilated wretches, who having fallen into
the opposite depravity, feel a horror for the sex, and
all that refers to it ; but who, devoured by insatiable
hunger would like to eat their rotten arms."

Ulloa, in 1797, says : " Leprosy is rather frequent
in hot climates ; it is unknown in Peruvian high-
lands. The chief cause of the disease in Peruvian
America has been the introduction of African
negroes. Muniz mentions that Fray Jose de la Trin-
idad took charge in 1822 of the leper hospital
which had been united with the incurables, in Lima,
and was called del Refugio. With the exception of
1853, when nine persons succumbed to the disease,
the average mortality from it was from two to six a
year. The "long- bearded and small- cloaked father,"
as he was called, died in 1878. It is impossible, ac-
cording to Muniz, to make a reliable statistic record
of leprosy in Peru ; the registers are few and insuffi-
cient. The decrease of the number of cases is a fact.
Leprosy has been very hard on the black race. Al-
most all the ancient inmates were emancipated
negroes. The disease affects Indians rarely. From.
1870 to 1886, there died in the Refugio five men and
five women ; four of them Chinese.

Now considering that leprosy has become almost
universal in Colombia, and that it has been almost
extinguished in Peru, we are led to suppose that in
the latter country great care was taken to isolate the
lepers ; for in no other way could that disease be
extinguished. Therefore leprosy must have been
rampant there. Such perfect isolation could only
result from a great horror of the disease. And if
such horror existed, would they be likely to bury

with their dead the images of the horrible i
It may be aeserted that the influence of the Church
isolated the lepers, so that no feeliog of horror is msc-
essary to explain their iaolatiou. But the Incas
never were under the influence of the Church, and
the Church egtabliehment existed in Colombia to aa
great an extent as in Peru.

lam inclined to believe that if these kuacos pot-
teries really represent disease manifestatioua, they
must be of the syphilitia kind. To succumb to
syphilis was to be the victim of a disease which was
not at the disposition of the poor, who could not
pay for the use of many women; and that use was
considered as the cause oi the disease. They had
not in those ancient times any idea that a bacillus
must be the cause of the disturbance. Therefore to
be buried as a syphilitic would probably be an honor,
rather than otherwise, in the eyes of the general peo-
ple, while to be buried as a leper would be quite a
different affair. Hence we may conclude that if cer-
tain deformities are found in ancient burial places, it
is more probable, at any rate, that they belong to
syphilis rather than to leprosy.

In Saladoa, ancient Arizona, considerable patho-
logic evidence was found hy Mr, Frank Hamilton
Gushing of abscess of the lower jaw and perforation
of the alveolar walls. In one case, part of the alve-
olus was lacking, giving to the jaw a very distorted
ajipearance. Now these Saladoans have been con-
sidered by many archfeologists aa allied to the Peru-
vians and the mound-builders of the Mississippi
valley on account of their Inca bones. Such a de-
formation would be very similar to what we see in
some specimens of huacos pottery; and it could be
only syphilis, as leprosy has never any efl'ect on the
skull. The man could not distort the soft tissues of
his jaw ; the disease must be in the bone.

Mr. Bandelier, the explorer who sent to New York
the huacos pottery which I have examined, has hie
headquarters on the Racred Island of Lake Titicaca,

26

13,000 feet above the sea level. It was from this
island that the original Inca descended to conquer
and civilize the barbaroas tribes of South America,
and to foand their capital, Cuzco, four centuries
before the arrival of Pizarro, 1000 A. D. Now on
these highlands syphilis had existed among the
Aymaras and Quechaas many hundred years before
the arrival of the Spaniards. Whatever evil these
Incas brought along with them, was likely, according
to all I have said before, to be syphilis.

In ancient Arizona, Mr. Frank Hamilton Gushing
found some burial places which he calls extra-muros
cemeteries, and he thinks they were for some kind of
outcast i>eople. It would be natural, especially for
such persons who know something of the history of
leprosy in Europe, to suspect that these places were
leprous burial grounds. But he informs me that his
examination of many hundred skeletons in the south-
western United States revealed no traces of leprosy
among the prehistoric population of America. The
importance of this statement consists in the special
relationship more than plausibly supposed to have ex-
isted between ancient Peru and Arizona. One of the
causes of this plausibility is the presence of llama,
gaanaco and vicuna representations in clays and in
petrographs buried with the dead. That animal is
supposed to have been extinct (by Mr. Bandolier) long
previous to the sixteenth century. Another is the
presence of holas or sling stones, such as are now used
in South America in the chase; the tombs furnished
only the stones, the sling is only to be found in pic-
torial form. There are also the knotted cords found
in sacrificial caves in the mountains surrounding
Salado City, which resemble closely the quipus or
sacred records of the Incas ; these knots are the hiero-
glyphs, or the alphabet of those ancient tribes. There
is, above all, the predominance among the Arizonians
of the Inca bone.

Mr. Gushing states that he did not find in Los
Muertos, one of these places of interment, either hair

or cerementB or anything that could have escaped de-'
Btruction for a thousand years ; he very naturally con-
cludes from one thousand to two thousand years at
least muat have elapsed since those corpses were
buried there.

The aheence of any evidence of leprosy in Arizona
will make the existence of the disease in pre-Colum-
bian Peru very improbable.

Professor Putnam, of Peabody Museum, Cam-
bridge, Mass., with whom I discuased this subject at
some length, is not of opinion that a horror of
leprosy in ancient Peru would stand in the way of
the burial of leprous representations with their dead.
"For," says he, "whatever custom has been trans- -I
mi t ted from generations to generations is, in Peru,!
always kept up, whatever might have been the events
and circumstances which might deprive the custom
of all meaning. Even if they do not understand the
meaning of a rite, they will perform it because their
fathers did." Mummies are now found in that
country, tied up in sacks, the false head sticking out,
tied up separately, just as they were in the distant
past. The custom was, and is still, to bury with the
dead such objects as might iudicate his condition of
life, or any peculiarity belonging to him as an indi-
vidual, even some circumstance peculiar to the time
in which he lived. There is a mummy iu the Peabody
Museum which was buried with a decree of the sov-
ereign Pontiff which was published at the time when
the man was living, and which, so far as we can see,
had nothing to do with him as an individual.

Professor Putnam tells of his discovery of a corpse
in one of the many stone graves scattered over Ten-
nessee, Arkansas and Miasouri, which presented a
curvature of the spine, and buried with the same he
found a piece of pottery representing that identical
curvature, Therefore we may expect, even if only
one such is found, that some relation existed between
deformities of deceased persons and the objects
which were buried with them. In Professor Put-

28

nam's museum, he informs me there is a piece of
huacos pottery, showing the side of the nose and the
side of the upper lip and part of the cheek eaten
away. The pathologists of Harvard University, who
examined this specimen, are of the opinion that these
deformities might represent lupus. The same pathol-
ogists are not able to affirm that the so-called evi-
dences of syphilis, in ancient bones of America, which
are so plentiful in the Peabody Museum, are of any
value to prove the disease. They question whether
syphilitic disease could produce effects which could
not be mistaken for the effects of some other diseases,
as tuberculosis, rheumatism, etc. Professor Putnam
personally has gone over the same ground as Pro-
fessor Joseph Jones. The latter thought he had
found unmistakable evidences of pre-Columbian
syphilis. Putnam found no evidences of the Ten-
nessee mounds, which he could swear to as being
certainly syphilitic.

I called Professor Putnam's attention to a Peru-
vian skull in the American Museum, of theBandelier
collection, which was being classified. It was an Inca
skull, and showed evidence of disease at the junction
of the parietal and frontal bones in the supratemporal
region ; a diseased spot of an inch and a half in diam-
eter. The bone was cancellated andeburnated, with
deep corrugations as if eaten by disease ; the tissue
was almost eaten through. But what was more pe-
culiar was that a knife mark so fine that it could
only be seen clearly with a glass, passed around the
diseased spot. When held to the light and exam-
ined from the inside, through the foramen magnum,
this part of the skull appeared almost entirely eaten
through. No evidence of disease except by this
transmission of light could be observed on the inter-
nal surface of the skull. Evidently an operation
had been made on a tumor or ulcer of the scalp, and
the instrument had left its mark on the bone beneath
the periosteum. This looks very much like syphilis.

Professor Putnam showed me a trephined Inca

nil which evidently had not been fractured.
was evident in this specimen that a round flap of
Bcalp had been removed before the operation. This
evidence cooBrsted in a whitening and a smoother ap-
pearance of the bone. Putnam thinks that if this
operation was really performed without any fracture
to warrant it, it may have been 'done to release some
evil spirit, which their superstition led them to sus-
pect was in the skull. My own opinion is that we
have here an esostosia, and one that might well have
been syphilitic.

According to Professor Putnam, there are numer-
ous evidences of intercourse between America and
Asia in very ancient times. " There were," says he,
" probably two routes from India to this country ; one
through the Malay archipelago and thence from
island to island, and slowly through numerous gene-
rations, up to the Aleutian Islands, where Behring's
Strait alone separated the slow invasion from the
great continent." Putnam supposes that when this
slow emigration had reached this extreme point, the
commercial population of America went to meet
them. I may here say that it would be just as prob-
able that the people who could creep from island to
island for centuries might have themselves made that
last step, and crossing the strait, entered in relation
with the population of the continent. The other route
is across the South Pacific Islands.

"If leprosy inoculated America before Columbus,
it must have occurred," says Professor Putnam, "very
early in the history of this continent. It must have
long antedated the earliest period at which it could
have inoculated Japan, 660 B. C. For the disease
must have come with that East Indian current, if
there was such current, when it touched South
America; and thiswas certainly long before 660 B.C."

Dr. Augustus Le Plongeon, whose explorations in

NoTG. — If leproi^F liail codki to Amerlcii from East Aala by thJaroatB,
we^onld harB-somc indlcntloua of it, by traoee left in the South Piujlflo
lalands. But ibere was never leprosy In choee Islanda.

30

Yucatan have already been referred to, has kindly
given me the following facts about his experiences in
Peru and Yucatan, as far as they relate to my subject :
"First as regards Peru. You may not be aware that
I have practiced medicine in Lima from 1862 to
1870, studying meanwhile ancient Inca civilization.
My collection of ceramics, dug up under my super-
vision from the huacos, was one of the most complete
in Lima when I left the city. My practice was very
extensive among all classes of society and I must
say that, at this moment, I do not recall having seen
cases of leprosy among the Indians. The cases I
recollect having seen were among the negroes partic-
ularly and the white descendants of Europeans,^ that
is the Creoles. Of course syphilis was, and is still com-
mon among the Indians. Anciently, throughout
America,it was for some reason unknown to me, regard-
ed as a "sacred disease." I have not used the Quichua
language for so many years that I have wellnigh
forgotten it. I do not remember if it contained a

word for leprosy Professor Bandelier,

who is now delving in the tombs of the ancient Peru-
vians has sent some of his finds to the Museum of
Natural History in Central Park. Among other
things a curious skull, with a deep hollow, caused I
should judge by syphilis, and a lot of curious jars,
etc. ... I have never heard that those affected
with leprosy in Peru were kept apart from other peo-
ple. I suppose that the cases were too few to attract
the attention of the authorities. As to Yucatan,
where I have resided during eleven years, mostly
among the aborigines, I do not recollect having met
with a single leprous case among them. There were
a few cases of syphilis, where they have had contact
with the whites. To-day the Indian population of
Yucatan seems to be a particularly healthy vigorous
race. I have seen cases of leprosy, but they were
confined to the Creoles. Two of the principal fami-
lies of Merida, the capital, are known to be leprous.

5 They suffered from elephantiasis.

Juan PeoD Contrerae, a member of said families who
generally intermarry among themselves, although
very wealthy, was at one time director of the Yuca-
tan Museum, and a disgusting object to look at, lit-
erally falling to pieces. Still he was commingling
with other people without hindrauce. Another such
case I saw at the Island of Cozumel. I repeat, the
cases are rare. I have no doubt that the disease was
known in the country ages before the advent of the
Spaniards. The Maya word for leprosy is nayvan,
from the verb nay, to corrode, to eat up. This is
not a name of modern invention; it ia found in the
dictionaries and vocabularies of the language made
by the Franciscans in the sixteenth century. I have
a small medical book written in Maya language by a
native, one hundred years ago, but I do not find in
it any mention of leprosy.

"My study of the mural paintings in the funeral
chamber of Prince Coh, at Chichen, also of the bas-
reliefs that adorn the walla of the public monuments
in that ancient city, proves to me that in remote
ages the inhabitants of Yucatan, in fact of all Cen-
tral America, had as close communication with
those of all other civilized countries as they have
to-day. They had close relations with India and
Indo-China, where they introduced their civilization,
as I show in my book ' Queen Moo and the Egyptian
Sphinx,' that will he given publicity in two or three
months. I discovered portraits of Carthagenians
sculptured on the walls; representations of negroes
from Africa, Mongolians from Eaat Asia, Burmese
from Indo-China, etc., painted and carved on pillars
and walls. In fact the Nagas, the serpent worship-
ers, who developed such high civilization in the
south of iudia and the Indian peninsula were immi-
grants from Pdtala (America), who reached Asia in
times anterior to the invasion of India by the
Aryans.

" I do not suppose that sailors in those times were
more careful than sailors in our days, and I have no

32

doubt that they spread diseases among the inhabi-
taDts of the countries they visited, just as the crews
of Captain Cook spread syphilis among those of the
islands in the Pacific. The communication between
Asia and America being then frequent there can be
no doubt that such contagious diseases as syphilis
and leprosy were disseminated throughout the earth's
inhabitants as they are to-day, and it seems to me
impossible to determine where such a peculiar disease
originated. We know that at one time syphilis was
as common in America, as leprosy in East India, and
it is most probable that the inhabitants of these
countries interchanged compliments ; those of Amer-
ica introducing syphilis into Asia, those of Asia im-
porting leprosy in America."

Diego de Landa, in a manuscript written in 1566
and entitled " Relaceon de las Cosas de Yucatan,^' in
a chapter entitled, " Varias Calamidades esperimen-
tadas en Yucatan enel sigh anterior d la conquista, hur-
racan, pestilencias guerras, etc." says, that " those who
escaped took heart of grace to build houses, and cul-
tivated the land, and multiplied themselves, being
much aided by fifteen years of good and healthy
weather, and that the last year was the most fertile
of all; as they began to reap their harvest there
broke out in the whole country some pestilential
fevers, which lasted twenty-four hours. After these
diseases abated, there came a stream of gnats. From
this pestilence many people died, and a great part of
the harvest remained ungathered. These miseries
were succeeded by a pestilence of large pimples
which rotted the body with great stench, so that their
limbs fell off in four or five days."

This is the only passage of the ^^Relaceon^' which
mentions anything having the least resemblance to
leprosy. There is falling off of the limbs, but they
fall off in four or five days, and it is almost evident
that the rottenness belonged to the soft tissues, and
not to the bone. It may have been smallpox.

In Cogolludo's ^^Historia de Yucatan*^ (Diego Lo-

tez Cogolludo, Madrid, 1688) where he gives a i ^^
Bcription of all the calamities, dieeaaeB especially,
which afflicted the peninsula, there is not ore line
that can be interpreted as a refereDce to leproey.

Note. — Milagrusa. que no fe, Kobe »u origen, etc. lliraclea of
all kinde due to an image of the Holy Mother. Cures an
apoHtema on tbe Bole of the foot, a tumor in tbe face, and in
the throat. Fevers of ever; description cured. Sick stom-
achs cured by the Holy Image, etc. — (Lib. xii, Cap. xis.)

De olros miiagros. — An Indian woman, having given birth
to a child, coald not for a whole hour eject the natural su-
perfluity, etc. Another feels Budden pains in the stomach,
etc. Another woman feels a pain in the temples, which
extends presently to the whole face ; Holy Image brought,
and patient cared. Fever of a youth cured. Other fever.
During five months a boy 14 years old had hnd fever, and
after awhile his face and his legs swelled. Cured.^Lib. xii,
Cap. XX.)

The conquerors and original colonists seeing the contin-
ual sufierings from diseases, of the poor, strangers as well
as aboriginals, founded a hospital, which has now existed for
eighty years and more, at the date of this writing. How they
founded it, the King being patron, how it was administered
at the expense of the city and intrusted to the monks of St.
Juan de Dios, is stated in this book, etc. — (Lib. i, Cap. xvf,
p. 21(3).

Death of Landa. The time came which the Divine Majesty
had appointed for giving to the blessed Bishop Don Fr.
Diego de Landa, the reward which his many services and
virtues merited ; he died in cansequenceof a bad cold which
he took while preaching on the passion and death of Christ.
He became feverish, and felt a puncture in the side. He
sent for counsel to our hospital and our physician con-
sidering the pain accompanying the fever, judged that it
was a pain of the side and bled him. The fiisliop said at
once that he believed himself to be dying and prepared for
bis last hour. Lot of absurd details. — (Lio. vi.Cap. xviii.)

Enfo-rnedad peliyrosti en Meridii,ano de 1609, etc. — In that same

Siar 1609, in the month of September, the inhabitants of
erida were much troubled b^f a disease ; the Spauiards had
had little experience of it in this country, and it was very
dangerous. It consisted in hot fever with measles and pus-
tules. FrooessioDS resorted to. At the end of that year the

which is not in the dictionary, and has some
honey.— (Lib. xii. Cap. i.)
Miiagro KotibilisHme eon unos Tndioa, etc. The miracles

34

with Indians is this, in two words : they were deeply buried
while digging, and by the intercession of San Diego, dug
out again. (No leprosy.) Divers other accidents are reported.
There was also a dying priest whom prayers recalled to life.
— (Lib. XII, Cap. x, p. 709.)

Desgracios procedentes a la peste^ etc. A number of ships
taken and burned at sea. In June the pestilence began in
Campeche, and soon the city was said to be entirely deserted.
Orations, processions, etc. At the end of July the disease
began in Merida, where many persons perished in a few
days. (No leprosy.) — (Lib. xii. Cap. xii.)

Varios accidentes con que morian los enfermoSt etc. Symp-
toms — Various accidents. Terrible headache and pains in
all the bones, which seemed to go to pieces, or to be pressed
as in a vise. After a short time violent fever sometimes, but
not always with delirium. Vomissements de sang corrompa^
and after this symptom few recovered ; others had a flux
of the belly, of choleraic humors. (Yellow fever?) — (Lib.
XII, Cap. XIV.)

De algunos senalados religiosos que, etc. Some distinguished
ecclesiastics who died of the pestilence. One mounts into
the pulpit all right, and comes down with the symptoms of
pestilence. Dies the eighth day. Another is infected while
taking care of the sick. Other cases of the same kind.
(Yellow fever?)— (Lib. xii. Cap. xv.)

Mr. Saville tells me that in the pottery of an-
cient Mexico there are symbolic pictures of death ;
human faces with blinded eyes. It is at least his
opinion that this extinction of the eyes means death ;
for the god of death of these peoples is always repre-
sented with a stick puncturing the eyes. But noth-
ing that can be considered as disease representations
has ever been found there.

In Chiapas, Mexico, he says images have been re-
cently found showing clubbed feet, arms in cramped
positions, etc. This find is believed by archaeolo-
gists to be exceedingly valuable, but it has not been,
as yet, much reported upon.

If leprosy existed in America in pre-Columbian
times, and if these deformations on huacos pottery
are intended to represent lepers, the same idea must
have been conceived previously in Japan, or Eastern
Asia in general, from whence the disease itself would
be likely to have come. But Prof. Edward S. Morse
writes me : " The pre-historic pottery of Japan has

35

no trace of lepers either incised, in relief, or painted.
Nor do the forme ever represent a natural object. In
early historic timeB, say from 1200 to 1500 years ago,
a soft reddish pottery band-made, and a hard gray
pottery, turned but not glazed, in very rare cases,
ehowed the form of natural objects."

Mr, Tanaka, a Japanese importer, who ia probably
as conversant with modern Japanese pottery and art
as any man living, affirms that he never saw the rep-
resentation of a ieper, either in pottery or in the
drawings of Japan.* The blind man is represented;
he is, in fact, considered as possessed of virtues and
powers refused to the crowd of men with regular
eyes; he is the massager and acupuncturer.

Under the reign of the Empress Suinin (A. D. 29-
70) the custom prevailed of burying living retainers
around the body of their masters. The living beings
were replaced by small images of clay, and that new
custom continued until 700 A. D. In 700, cremation
began ; it was first practiced by a Buddhist priest.
When the custom of cremation extended, the burial
of retainers, or of clay images, had no longer any sig-
nificance in the mind of these primitive peoples.
These accompaniments were intended for a body, not
for a heap of ashes. Cremation was, in Japan at
least a Buddhistic, a religious institution. It was
not intended and especially used for the destruction
of leprous cadavers. Even now lepers are excluded
from the burial rites of cremation. It is probable
that even in our day there is more cremation than

*Noi'e.~liitlie"JtpuieBeUBiiaB,l for Ladles," a book onetlqaettepub-
UBbedln ibe, elKhceentb centur;, ibere 1b a drawing of the Empress
Gemmyo (A. D. 703-T2I.) who washed a thouBaod lepers with her own
hands and Cook eeueral care of them. (Sbe built the flrst leper hospital
In Japan.) In tnis picture a tnbercnlnted leper U represented. He baa
tbeleoDlneface.wlthoal, however. loss of nose. In a Jai^abeae book
called "HakkeDden," wbJcb meaos " atory of Eight Warriors," written
early in this ueuturf, there Is a representation of a leprous bei!gar. P»
Is without a noae and without hair: Mn refl lace is hypetcrouhled Bi

(UbBroulatBd. His upper lip is representeil much — "•^' ■'— ■• —

lated. His toee are gone, the bauds abow scabs a

■re the onl]' repreaen Cations of leprosy kuov

that the loss of nose and upper Up In Japitu li

the streets. This defomiatlDn in Japan, whien is a leproua oouni

(there are lOUWMl lepers in Japan) is cousldered always as sypblUtic.

B 19 hypettroi . . . ._
h swollen and tul}erou-

36

interment in Japan ; but lepers are severely excluded
from the former. We might very plausibly conclude,
I think, that if leprosy came to this country from
East Asia, -the absence of skeletons with leprous in-
dications is very significant; for, as I have just said,
leprous bodies were not cremated, and therefore ought
to be found occasionallv. Even if these bodies had
been as a rule cremated, would not some of them, or
parts of them have escaped the incineration? If we
can not find any trace of the mutilations peculiar to
leprosy, we may safely conclude that leprosy did
not exist at all here.

Dr. Brinton and Professor Powell assert that the
civilization of America is autochthonous; that is,
it did not come from East Asia, or from any other
country. Let us now ask ourselves here whut autoch-
thony after all means? Can it mean, according to
etymology, anything else but the origination out of
certain ground, certain environments, and certain
circumstances of certain conditions of life? There
must be evidently diseases which originate in circum-
stances which are only found in the place where they
originate; and these I should call autochthonous.
What is, after all, the- meaning of autochthony, speak-
ing of diseases? It is natural to suppose that in
every human body there are all the possibilities nec-
essary to produce any disease. Call them germs, or
what you will. Suppose that an individual in the
city of New York finds himself and his possibilities
placed by chance in such a condition that a disease,
up to his time unknown, develops in him and that, in
some manner, it is transmitted. Well, the disease
would be autochthonous in New York, as yellow
fever probably was in Yucatan. Now it is extremely
reasonable to believe that at the same time, or at
some other time, before or after, the same phenomena
had occurred in many other places. If we con-
sider this, to what does the autochthony of disease
come?

Is leprosy autochthonous wherever we find it, or

37

must we suppose that it comsB in every case from
inoculatioD?

If leprosy esiBted in America before Columbus, if
Dot autochthonous, it must have come from East
Aaia, or indirectly from its ancient home in Africa,
or else these countries were inoculated from
America. I believe that the leprse bacillus re-
quires its own soil to thrive upon and that moat indi-
viduals would resist its development as well as other
disease germs are resisted. I, for my part, do not
believe that the leprEe bacillus is the real factor in
the production of leprosy, or that a bacillus is the
real cause of disease. I believe that there is a cause
of the disease of which the bacillus is only a symp-
tom. What the nature of that cause is I can not say,
and nobody can aay ; modes of life, kind of food,
peouliaritiea of climate, clothing, morals, etc. Id all
cases, where certain conditiona belonging to these
factors exist, it may be that the same kind of bacilli
find their living; the microbes may have nothing
to do with it, except that under these conditions
alone they can live. Under certain conditions of life,
certain bacilli take birth. It is not the bacillus that
is the cause of the damage that ensues ; it is the con-
dition which allows it to prosper.

Profeesor Stillesays: "The^aupreme puzzle is the
primary source of each specific germ. Aa yet no
Darwin haa arisen to show even the possibility of the
evolution of such germa. To name them bacteria,
and assign to each disease a specific bacterium, only
removes the difficulty one stage backward."

If the ancient races of America came from East
Aaia it is reasonable to suppose that they came
through Japan, Yesso, the Kurile Islands and Aleu-
tian Islands. There are stone age, arrow head con-
nections between Japan, Yesso, the Kurile and Aleu-
tian Islands; there ace syphilitic connections between
Japan, Vancouver, Mississippi mound-builders and
Mexico. There ia no connection in pottery, or in
modee of burial between these two civilizations.

38

There is, however, a skull couneotion between the
Indians of Mexico (Tarahnmares), anoient Arizoni-
ans (Saladoans) and ancient Peruvians. From these
facts we may suppose that there was a migration
from East Asia to America.

There is no evidence from Behring's Strait down
to South America, that any leprous inoculation took
place through this migration. If any leprous inocu-
lation into Peruvian populations took place, it must
have been either through the Spaniards or, as.Le
Plongeon assumes, directly from India. It could not
have come through the islands of Japan, that is preced-
ing their occupation by the present Japanese race ; for
the Ainos, as long as history knows anything about
them, never were afflicted with leprosy, and they are
immune to-day.

We must therefore conclude that if leprosy came
from India to America, it must have come by another
route than that which brought syphilis. "

Dr. Franz Boas, who has given to the study of
American races more time and interest perhaps than
any other man living, who has just returned from an
investigation of the Indian races of British Colum-
bia, tells me that the Tenachca and Nass River In-
dians, whose diet consists mainly of small fish,
smelts and shell fish (this is the diet which has
always been supposed by the common people, and by
many doctors, to be the predisposing diet of lepers)
are not leprous, but exceedingly syphilitic. Loco-
motor ataxia is almost epidemic among them. Dr.
Gowers, of London, and many of our own specialists
assert that locomotor ataxia succeeds syphilis, and
that without syphilis there is very little locomotor
ataxia. This is not my opinion. My experience in
Japan, during two years of hard work, made it evi-
dent to me that in that region where they have lived
in close familiarity with syphilk for thirteen hundred
years, there never was, and there is' not any locomo-
tor ataxia. The same gentleman says that I am
probably right in stating that locomotor ataxia has

no syphilitic origin ; for the old people of that tribe
have a great deal more of locomotor ataxia than the
younger and yet are less syphilitic. Beaidee, other
tribes in that region examined by him have not loco-
motor ataxia at all, and yet have more syphilitic dis-
ease than the Tenachca Indians. Nor is it my belief,
and I have had a great experience of such cases, that
locomotor ataxia can be considered as a sequela or
attenuated form of leprosy. For the disease called
locomotor ataxia does not exist in Japan. If it was
an attenuated form of leprosy, it would be found
there. Therefore no matter how rampant the disease
may be in British Columbia to-day, there is no
evidence from thie fact, that leprosy existed in
British Columbia in pre-Columbian days. '

Whether this syphilis of British Columbia came
from East Asia or not, he is unable to say. He does
not know of leprosy in any American primitive race.

Dr. Wm. F. Whitney, Curator of the Warren Ana-
tomical Museum, Harvard Medical School, in an
article entitled, "Notes on the Anomalies, Injuries
and Diseases of the Bones of the Native Races of
North America," published in the 18th and 19th
Annual Reports of the Peabody Museum of Ameri-
can Archffiology and Ethnology, Cambridge, 1886,
mentions among the diseases various exostoses with
and without eburnation, and among the hyperostoses
the subjects were as a rule persons past middle life.
He says, moreover, that the flattened beads of the
ancient Peruviana show a]so a large proportion of
hyperostosis.

Periostitis is manifested by a deposit of new bone
of greater or less extent, along the shaft of some of
the long bones, especially the tibia. (For the evi-
dence necessary to prove that this, as well as other
changes, are the results of Byphilie, see Boston Medi-
caland Surgical /onraai, vol. cviii, p. 365). The dis-
ease known as chronic rheumatic arthritis has also
left its marks in roughness and deposits on the edges
of the articular surfaces and on the bodies of the

40

vertebrae. Under the heading, "Caries," he mentions
three remarkable specimens.

The first, 17,223, stone-grave mound, near Nash-
villfe, Tenn., affected the spine and there resulted an
extreme case of anterior angular curvature. The
disease had destroyed almost the whole of the bodies
of the lower cervical, or upper dorsal vertebrae, and
they had become united in a firm mass. The spinal
column at this point was bent forward so as almost to
touch, there being but a few centimeters distance be-
tween what are taken to be the bodies of the fourth
cervical and fifth dorsal vertebrae. The amount of
deformity must have been very great.

In this connection it is curious to note that there
*are in the museum, found in the stone graves of
children in Tennessee, little clay images which are
faithful representations of persons affected with Potts
disease, and that many of the water bottles from the
stone graves of Tennessee, and from the mounds of
Missouri, represent women with hunchbacks.

From the mental acuteness says Dr. Whitney, which
is so often associated with this malady, it is easy to
conceive that such deformed people may have been
held in peculiar veneration, or there may have been
some superstition in regard to their protective influ-
ence. At all events this spine furnishes the veritable
proof of the existence of persons so afflicted.

The second case of caries is found in bones, 27,372,
from a stone grave in Brentwood, Tennessee. The
articulating surfaces of the right femur and tibia
forming the knee joint, show marked erosions of the
smooth hard layer of bone on which the cartilage
rests. At first sight, this might be attributed to the
results of weathering ; but closer inspection reveals
the fact that there is a marked increase in the size of
the openings for the nutrient vessels for some dis-
tance from the joint on either side, and that here
and there the shafts are roughened by small pieces of
newly formed bone. From this the inference is justi-
fied that the destruction noted above is the result of

41

a chronic iDflammafcion which in no way differs I
the so-calied "white swelling" of the knee thi
always to be found in the snrgical wards of any large
bospital.

In the third caae, 1 1,891, etone grave mound, Nash-
ville, Tenn., it ia the ankle joint that is implicated.
The opposing surfaces of the left tibia and astragalus
are eutirely honeycombed by deep depreseions, separ-
ated by irregularly shaped bony trabecule with round-
ed or roughened edges. In the lower part of the tibia
ia seen a cavity communicating with the external sur-
face by a small canal opening through the inner
malleolus. Lying free in the cavity is a piece of
dead bone, too large to pass through the hole.

These cases are interesting from the fact that such
processes are now supposed to be the result of a local
tuberculosis, aud if this existed it is fair to assume
that the internal organs musthave suffered also from
tuberculosis, the most common seat of which ia in
the lungs in some form of pulmonary consumption.
This assumption is verified by one of the early writ-
ers on the habits and life of the Indians, who says
*of them ; " C'est pent etre du ineme principe et de ce
qu'ils ont tovjour8 i'esloma et la poitrine decov/verte,
qu'ils contractent une espece de phthisie, qui les minant
peu d peu en conduit la plus grande partie au Tombeau
et S laquelle its n'ont pu encore trouver du remede."
(Lafitau, vol. ii, p. 360, Paris, 1724:.)— Translation.
(It ia perhaps for the same cause and from the fact
that they have always the stomach and chest uncov-
ered that they contract a kind of phthiaia which,
wearing them out, little by 1 ittle, brings moat of them
to the grave, and for which they have not as yet beeu
able to find a remedy.)

There remain to note a few skulla which have
cicatrices pointing to more or less extensive inflam-
mation, the cauae of which is still obscure.

The skull of a female'bf middle life, 18.264, from
a stone-grave mound on the Little Harpeth River,
Tennessee, haa a number of slight cicatrized depres-

43

sions, more or leee dietinctly connecting, paesing
completely round the head on the line of the fore-
head. Their form is chiefly linear, but in one or two
places they cover spote as lar^e as a finger nail. The
parietal protuberanceB and frontal bone show the
moat extensive marks, and from the latter it passes
down over the bridge of the nose. The right lach-
rymal canal is filled by a new and symmetrical growth
of bone almost occluding it.

Another skull presenting somewhat similar cica-
trices, is 733, from a mound in Kentucky, in the
Army Medical Museum at Washington. The whole
surface of the parietal, frontal and occipital bonea
IB covered by shallow cicatrices having a firm base,
and near which are minute perforations through the
intact outer table into the diploe. Some of these
depressions look as if they had been made by plac-
ing a finger on the softened bone, while others are
slightly star-shaped or else are linear and anasto-
mose, surrounding islands of unaffected bone.

The general and extensive changes of these two
skulls can be explained best by the assumption of a
syphilitic affection. But the appearances are not
quite charactetistic. There is wanting the peculiar
ivory-like luster to the healed spots, and the accom-
panying sclerosis of the bone in general.

In No. 20,180, an imperfect calvarium from Stan-
ley Mound, St, Francis River, are a number of very
slightly depressed and radiating cicatrices situated
chiefly on the frontal bone. The grooves for the
arteries are very deep on the inside, but the bone is
not in general sclerosed.

. The maxillary bones are of interest and it is a pity
that the bones of the face are in such a fragmentary
condition that the exact extent of the lesions can not
be satisfactorily made out. In the right antrum of
Highmore, the posterior wall is thickened and the
superior is covered with spicular exostoses, while a
large linear one reaches from near the opening across
the bottom. The whole inner surface of the bone is

collection of photograph I.

existed during life. A fragment of the rigiit sida of '
the " sella Turcica," witli ao attached bit of the great
wing of the sphenoid and pterygoid plates showB
marks of roughening similar to that on the maxilla
and palate hones, as if an inflammation had extended
upward from this point. The edge of the anterior '

"45

narea eeems more rounded and deeper than normal.

There ia less remaining of the left maxilla than of
the right, but the same rotighnees of the internal
surface is seen, and this hae extended forward, par-
tially filling up the edge of the anterior nares on
this side. The socket of the first molar, which lies
directly beneath, has evidently been the seat of an
abscess, and it is poesible that this stands in a causal
relation to the changes seen on the bones bounding the
nasal fosam. It would be difficult, however, to bring
this into relation with the cicatrices on the forehead.

At the Army Medical Museum in Washington are
the bones of the face, with the frontal bone attached,
(748) from a mound in Kentucky, showing the prob-
able effects of a large tumor. This had completely
filled up the nasal foss^ and had rounded off the
edges of the nasal and maxillary bones forming the
boundaries of the anterior nares. The septum of
the nose and turbinated bones have entirely disap-
peared and the ethmoidal cells were freely opened.
Through the hard palate there is an oval opening
extending from just behind the alveolar process
through the entire length of the hard palate, leaving
a narrow strip of bone on each side. The edges of
this opening are rounded off similarly to those of the
nose. Possibly there may have been a congenital
cleft palate into the opening of which the new growth
extended.

From these facts we conclude that there exist evi-
dences of tuberculosis and syphilis in the remains
of the ancient races, but no evidences of leprosy.
And we further may conclude that some ancient
races of America buried images, representing the
diseases with which they were afflicted. We have
good reasons, at any rate, to believe that-the ancient
Peruvians intended to represent on their huacos pot-
tery, if a disease at all was represented, one which
we have good reasons to believe was considered by
them as aristocratic and sacred.

Dr. Emil Schmidt, in answer to my ioquines as to

46

evidences of leprosy in Peruvian antiquities known
to him, says : "As to your questions about pre-Colum-
bian leprosy in America, I looked once more over my
collection of Peruvian skulls and mummies (more
than eighty specimens), but with quite negative re-
sults. I do not remember to have found any evidence
of pre-Columbian leprosy in other collections ex-
amined before. We have here, in the Leipziger
Museum f iir Volkerkunde, a valuable collection of old
Peruvian pottery ; unfortunately, it is packed up in
the museum, being transferred in another building.
A few years ago I examined this collection rather
closely, and I am sure I should not have overlooked
them, if there were any unmistakable indications of
leprosy."

I have addressed the following inquiry to Dr.
Augustus Le Plongeon : "I can not see any positive
facts showing that leprosy existed on this continent
before the arrival of the Spaniards, except the possi-
bility produced by the great intercourse with Hindo-
stan, Indo- China and Burmah, to which you seem to
attach much importance, and those huacos potteries,
on which Dr. Muniz thinks he found leprous repre-
sentations. Have you ever seen any indications on
any of the works of art of Yucatan of any repre-
sentations which you might consider as relating to
leprosy? Have you ever seen any representation of
mutilated hands or feet? Did you ever see any
corpses with such mutilated hands or feet? Upon
what do you base your belief in the existence of
leprosy in Yucatan, before Columbus, beside the
intercourse of that land with leprous countries?"

The following is his reply : " As I have told you in
my former letter, I have not investigated in my stud-
ies if a particular kind of disease existed on this
western continent before the arrival of the Span-
iards, but I regard it as probable, in view of the com-
munications that certainlv existed between its inhab-
itants and those of all other countries, that diseases
existing in said countries were propagated among

47

them, as they are to-day. Leprosy do doubt existed,
since they had a word to deeignate it, and their rela-
tioDS with Southern India were quite frequent. In
my book soon to appear, " Queen Moo and the Egyp-
tian Sphinx," you will see the nature of their rela-
tions. The ceramics of the Mayas, at least the pieces
I have seen, were ornanieDtal, of a very different
character from the Peruvian; on them were never,
as far as I know, represented any of nature's deformi-
ties. The Maya ethics were of a more refined nature
than those of the Peruvians. No representation on
them recalls any infirmity to which the human
body is subject. Their paintings and sculptures por-
tray battle scenes, domestic life, religious and other
rites and ceremonies, historical events, etc.

"I repeat, I do not know that leprosy existed
among the Mayas in pre-Columbian times. I sup-
pose it did, because they had a name for it, Naycam,
which would not happen unless they had some knowl-
edge of the diaeaee."

Here we see that Dr. LePlongeon has two founda-
tions for his assertion that leprosy existed here be-
fore the Conquest: first, the probability of its hav-
ing been introduced by the various relations of the
country with Southern India; then the traditional
name for it, which was Naycam, from the word Nay,
to eat away, or rot. As to the first, we may say, it
does not hold water, New York has a thousand times
more communication with all parts of the world than
Yucatan had with India, and yet it is not a leprous
city. As to the second argument, Dr. Gustave Briihl
has shown in his studies on pre-Columbian syphilis
in America, that the Mexicans and the Mayas, and
also the Quechnas and Aymaras, of Peru, had names
for syphilis before the Spaniards came. He argues
that diseases introduced by the Conquerors were des-
ignated by the Naturals, as a rule, by some reference
to the characteristic symptom, and that therefore
syphilis especially was of pre-Columbian origin, as
its name was not so designated by the Mexicans,

48

Mayas, Quechuas and Aymaras. Now the name Nay-
cam^ which means an eating away, rotting, would
have to be considered as the name of a disease intro-
duced by the Spaniards, and beside it might be ap-
plied as naturally to lupus and syphilis as to leprosy.

I addressed also a letter to Mr. Clarence B. Moore,
whose archaeological work in Florida is so well known
and appreciated. The following is his reply :

" My mound work has been almost entirely con-
fined to Florida, where I have opened about one hun-
dred and twenty-five mounds, nearly all of which I
have totally demolished. My experience, then, re-
lates only to Florida.

"I have found a considerable number of patho-
logic specimens during my five years of exploration.
In referring to these specimens I shall exclude all
cases of fracture, as I take it you are especially in-
terested in diseased conditions of the bones.

" I have never seen any atrophy of the finger bones,
such as was indicated in your photograph, but it
must be remembered that in nearlv all the Florida
mounds the form of burial is of the bunched variety,
i. e., skeletal remains of bodies previously exposed
until the flesh had left the bones were buried in little
piles, or scattered throughout the mound. In these in-
terments the long bones and crania figured principally.
Bones of the hands and of the feet, the vertebrae, etc.,
are seldom met with. Nevertheless, in some of the larg-
est mounds, burials in anatomical order were found.

" The question which principally interests archaeol-
ogists is as to the occurrence of syphilis in pre-
Columbian times. Dr. Joseph Jones in his ' An-
tiquities of Tennessee,^ published by the Smith-
sonian, writes at considerable length to prove the
existence of this disease among the men who made
the stone graves and as these sepulchres are, I think,
admitted by all to be pre-Columbian, he virtually
argues in favor of the existence of syphilis amon^
the aborigines previous to the coming of the whites.

"Dr. Jones wrote some time ago, and it has been

lupiitaied root. Wluo or water hottle,
said to be pn^-ColumbluD. BaiiddLur

50

shown that the specimens from which he drew his
conclusions did not show positively the ravages of
syphilis, but might have presented the same appear-
ance through changes arising from other causes.

"Dr. Hyde, American Journal of Medical Sciences,
1891, has treated in an interesting and sensible way
the occurrence of this blood disorder, under the head-
ing, (I think) 'Pre-Columbian Syphilis.' Dr. Hyde
arrives at the conclusion, as I remember the paper,
that it would be absolutely necessary to show they
were unmistakably syphilitic bones encountered in
the mounds, that these mounds were of unquestion-
ably pre-Columbian origin. To this I might add (I
do not recall whether Dr. Hyde refers to it) that in
mounds of great age are often found intrusive, or
secondary burials. Within the past week I have ex-
humed a body with remnants of clothing and feath-
ers belonging to a pillow. Later Indians, as for in-
stance the Seminoles, who were doubtless infected,
may have been buried in mounds, while to my knowl-
edge negroes and whites have been buried in ancient
tumuli. These burials, however, are never over three
feet below the surface and by careful observation as
to depth all chance of basing conclusions on late
burials may be excluded.

"The question of pre- and post- Columbian mounds
is warmly debated by archaeologists. The Smith-
sonian, all of whose work is done by agents while
conclusions are drawn at desks one thousand miles
away, believes in the existence of many post-Colum-
bian mounds of importance. On the other hand all
independent field- workers, such as Professor Putnam,
Cushing, Moorehead, Fowke, Thurston, of Tennessee,
and, in an humble way, myself, have yet to find any
thing in a mound of importance, much below the
surface, which in any way indicates contact with the
whites. I am not speaking now of Florida, but of
the entire country. Articles distinctly European are
glass, glazed earthenware, iron, lead, pewter, brass,
bronze, etc., etc. The Smithsonian has maintained

1

51

that the copper of the mounda must be largely Euro
3ean and the mounds consequently of a late date. 1
recent writer, however, has pointed out that it i
untenable to suppose that aborigines having inter
course with Europeans and obtaining copper from
them should bury this copper, with a great variety o
objects all distinctly aboriginal, and has. moreover

■

oolleotlUQ of phDtOKr.ipha of le|.rouB deforuiik'.ioQa.

by a cloud of analyses shown that the copper of the
mounds is pure native metallic copper, to which tht
aborigiuea had access and which ia highly maileabl
and that this mound copper has nothing in common
with the products of the imperfect smelting pro
cesses of the highly arsenical European sulphides

52

used during the fifteenth, sixteenth and seventeenth
centuries.

" In Florida, in mounds of considerable size, a num-
ber of feet below the surface, beneath undisturbed
strata, associated with objects of aboriginal art only,
I have found a considerable number of long bones
which had suffered from periostitis and osteitis of
both the rarefying and condensing forms, as shown by
general enlargement of the bone with irregularities
of the surface, local nodular swellings, roughening
and spiculation of the surface, etc. None^ of these
bones have been submitted to thorough examination
by experts, and it is therefore impossible to say posi-
tively whether any show the marks of venereal
trouble.

*' At the present time, both archaeologists and phy-
sicians are inclined to attach little credence to the
existence of pre-Columbian syphilis.

'* Most of my specimens are at the Academy of
Natural Sciences, 19th and Race Streets, Philadelphia,
where Dr. Dixon, the Curator, would doubtless be
happy to have you examine them. I have written at
considerable length as I have always maintained that
the opinion of any one is valueless unless it is based
upon substantial facts."

Dr Prince A. Morrow, ex President of the Ameri-
can Dermatological Association, who examined per-
sonally and very carefully the lepers of Molokai,
Sandwich Islands, and who is, I believe, the highest
authority on leprosy in this country, does not re-
member seeing a leper who had lost his upper lip,
nor does he think that such a loss is a leprous mani-
festation. He thinks, as I do, that if the authors of
those huacos potteries had intended to represent lep-
rous phenomena, we should find in their work muti-
lated fingers and toes. In the American Museum
there is a huacos pot^, a wine bottle in the shape of a
naturally sized foot, with circular flap removed from
the top of the bottle, the bone representing the top

I Bandelier collection.

53

of the bottle. The foot is represented swollen, with
toes placed on the end in a peculiar way, but with
nails showing naturally. Evidently some disease is
meant which required amputation. Dr. Morrow
kindly allows me the use of one of his photographs
that of a leper foot (not requiring amputation, how-
ever). You will find side by side here the photo-
graphs of the bottle and that of Dr. Morrow, the
latter belonging to a Sandwich Island leper. The
only difference is, as will be seen, the presence of
every toe on the bottle, while the photographed leper
foot shows but two toes remaining. This lack of
mutilation and the amputation show to me that it
was not leprosy which the potter wanted to repre-
sent.

I print here, side by side, photographs of loss of nose
deformation by lupus, by syphilis, by leprosy. The
leper apparently has lost his upper lip, with his nose.
This last is taken from Leloir^s well-known work. I
also print the characteristic deformations of fingers
and toes of lepers, according to photographs sent me
by Dr. Morrow. I print also photographs of huacos
pottery, representing deformations. Also a photo-
graph showing leprous tuberculation of the face.
This mutilation of the fingers, and this tuberculation
of the face, are the most striking features of the dis-
ease. Is it not probable, therefore, that if those an-
cient Peruvians had intended to represent leprosy in
the huacos pottery they would have shown a tubercu-
lated face or a deformed hand?

There lives in France (Beam), in the Pyreneean
regions, a class of people called Cagots, who have
deformations of the finger- and toe- tips, elevated
and arched nails, fissures and cracks, sometimes
ulcers of the epidermis and ungual matrix, a reduc-
tion of hair, more rarely certain deformations of the
phalanges, and some anesthetic cutaneous patches.
M. Magitot and M. Zambaco have studied these de-
formations and consider them as being of a leprous
nature, being supported in this theory by historical

54

documenta, local traditione and other pcoofa, etymo-
logical and philological. These people repreBeiit an
instance of anrvival in extreme attenuation of the
genuine leper, bo widely spread in southwest France
from the thirteenth to the sixteenth century.

Ill the Academy of Medicine, of Paris, 1893, in a
discussion on leprosy, and on the question, "Are there

in countries reported non-leprous, as France and
especially in its northern regions, also in Parie, ves-
tiges of ancient lepra?" M. Leloir mentions a case of
multiple cutaneous gangrenous plaques connected
with a lesion of the nervous system, which might
have been lazarine lepra. He also, in his report, re-

55

fera to what he said previously ou leprosy in Nor-
way, aud quotes three cases, in which the diagnostic
of lazarine leprosy was imposed: "In these three
cases," says he, "we are in the presence of French

DoBtrnoHvB IksIoii of noae nod upper Up, typipnl ol BSphlUs. Pl.'iaa.
Cllniqne <ic in Maladle Syi.hllitlqua. Par M. S. Devercle, Paris, 18SS.

It de I'arrtfre bouche i

patients, born in France, of French parents, and who
had never left their own country (Paris and the De-
partment of the North). Certainly if these patients

56

had lived in leper countries one would have found
the diagnostic of the mutilating lepra, the lazarine
lepra. As it is, these affections, are simply called
problems. Arc not these degenerated leprosies vestiges of
the lepra of old f'

Leloir, at Lille, in two clinics, showed four cases of
unnamed affections, simulating systematized nervous
lepra, or mixed lepra. The first of these accidents
was that of a man born in the vicinity of Cambrai,
who had never left the region of the north, and pre-
sented all the symptoms of systematized nervous
lepra.

The second was a thresher, 46 years old, pension-
naire at the General Hospital, born in the vicinity of
Bergnes ; he had never been a soldier and had never
left French Flanders. This patient presented in the
highest degree the characters of the systematized
nervous lepra. M. Leloir made the histologic exam-
ination of the pus taken from the cutaneous ulcera-
tions, and from a small fragment of skin bordering on
an ulceration ; he found nothing characteristic. He
found two bacilli, showing the histo-chemic reactions
of the leprous bacilli, and tolerably well their char-
acters ; " but you know," says he, " how abundant the
lepra bacilli generally are in leprous tissues."

The third observation concerns a shepherd, 66 years
of age, born near Fauguembergnes (Pas-de-Calais),
who had never left Artois and the Flanders.

The fourth observation was the case of a woman
aged 58, who had never been outside of French
Flanders. This was a quite remarkable case of sys-
tematized nervous lepra. At the autopsy, pronounced
alterations of the nerves of the limbs were found. "

Leloir mentions another case, in 1892, a patient of
his service, born near Dunkerque, and who had never
been outside his native country ; he was affected with
trophic troubles, muscular and cutaneous, resembling
much, in certain respects, those caused by the syste-
matized nervous lepra, but probably of syringomye-
litic origin ; this gave occasion to M. Leloir to agitate

again, in a clinical lesBoo, tlie question as to the per-
■siatence of the vestigee of ancient Jepra in France.

"Taking ground on the phenomena obaerved in
those siibiecte," says M. Leloir, "I remarked in 1885,

Li^pra Miberauli
luberouleuiB sjfllemmiHKB imrviiii
le pre, par Lfl loir. I'srla, IBSU. PI.

in my clinics at the Hospital Saint Souveur, that in
these five observationa we have to deal with subjects
■affected with lesions which resemble much those of

68

Bystematized nervous lepra, deforming or mutilating;
those of the systematized nervous lepra at the period
of the achromic and hyperchromia specks; of the
lepra called lazarine (systematized nervous lepra
with leprous erythema, pemphigoid and escharotic)
and finally, of mixed lepra."

Were these cases of true leprosy, as one would cer-
tainly be inclined to believe at first glance? But,
if so, where was thelepra contracted? This objection,
Leloir says, might, however, be discarded, if we sup-
posed ourselves in the presence of autochthonous
lepra, of vestiges of the ancient lepra which covered
Europe, and France especially, up to the middle of
the fifteenth century. He emphasized once more the
fact that quite possibly a disease, which at the death
of Louis VIII. (1229), had necessitated the creation
of 2,000 leproseries in France, and of 19,000 throughout
Christendom, had not entirely disappeared from the
countries where it was believed to have been extinct
for centuries.

He adds, however, that such a theory could not pass
from the domain of hypothesis, to the domain
really scientific, unless the ken of future observers
can be connected in an incontrovertible fashion with
lepra, on the basis of a careful clinical, anatomo-
pathologic and bacteriologic study.

Now in the five observations which furnished a
basis for his communications, and his lessons, if the
patients had much in common with real lepers, it must
nevertheless be confessed that certain clinical details,
(for instance, the absence of paralysis of the orbicularis
of the eyelids, with anesthesia of the face, etc.) did not
tally exactly with the lepra diagnostic, and that there
was no bacteriologic criterium at all.

" It might, however," says Leloir, " be conceived
possible that these cases of autochthonous lepra,
vestiges of the ancient lepra, presented themselves
to-day under an aspect slightly modified, the disease
having, as it were, degenerated since the Middle
Ages."

59

M. Leloir thanks M. Zambaco-Pacha, for giving
fresh support to the hypothesis expreaeed by the
Lille profeasoF, in 1884, 1885 and 1886. by his works
on the Cagots o£ Bretagne. Only, he thinks that M.

Zambaco's labors do not give uh the decisive, c
elusive proof of the persistence of ancient lepra
the individuals described by him. " Until he fi

60

in them, Hansen's bacillus, one must be allowed to
doubt, in fact, one must doubt.

*' I content myself with referring to the Chapter
' Diagnostic,' of my Treatise on Lepra, where it will be
seen how difficult the diagnosis of this disease is
sometimes. If what I say in that chapter, and what
I said in 1889 in the Annals of Dermatology, in speak-
ing of a patient of my service whose observation was
published by my interne, M.Baade, and subsequently
published again by M. Thibierge in the Medical So-
ciety of the Hospitals, is true, if lepra can be present
unperceived before the most experienced doctors, if
they are not perfect leprologists, it is not less recip-
rocally true that we must be extremely cautious, lest
we confound several quite different diseases with
lepra. This is especially to apply to the systematized
nervous lepra, a real specific polyneuritis, which may
be easily confounded with a number of affections of
a tropho- neurotic origin.

"As I said in my Treatise on Lepra, it can easily
be conceived that as systematized nervous lepra is
nothing but a specific polyneuritis, many affections
of nervous origin are confused with it. But even this
specific character of the leprous neuritis is cause that
in its character, in its evolution, in its dissemination,
in its localization in certain nerves, etc., it presents
characters so different from those we are used
to observe, such a special stamp, that in general the
diagnostic will be easy enough for a physician who
knows something about systematized nervous lepra.

" I will conclude in a few words :

1. "As I have shown with regard to the region of
the North and for Paris in 1884-85. and as has been
shown in 1892 by M. Zambaco-Pacha for Bretagne,
there are in France persons affected with nameless
diseases, bearing a strong resemblance to lepra.

2. "As I asserted in 1884-85, and as has been
affirmed in print by M. Zambaco-Pacha in 1892, it is
possible that we are in these cases confronted with
vestiges more or less degenerated of the ancient lepra,

61

which had invaded all Fra,nce and Europe in the
Middle Af;ea.

3. "This theory is plausible, suggestive, but it is
still in wantof a scientific demonstration founded on
a set of facts carefully observed and carefully de-
scribed from an anatonio-pathologic and bacteriologic
point of view."

Thus we see that, if we had easea with such deform-
ations as may have existed in Peru, and which the
huacos pottery is claimed to represent, not even that
would be sufficient proof of the existence of leprosy,
as long as mutilation of hands and feet, and tuber-
culation of face, were absent. Evidence of tropho-
neuritic destruction is not sufficient to make us assume
leprosy. Nor would even syringomyelia, if it is
existent in British Columbia, be proof of the exist-
ence of leprosy in pre-Columbian times.

There is a little pamphlet, published in London,
18S9, by a member of the American Ethnological So-
ciety ; it is entitled " Tepeu : the Hypothetical Migra-
tions of Morbus AmericanuB." Tepeu is the Quiche
name for syphilis, meaning also nobility. The au-
thor claims that the investigations among the
Natchez, and the mound-builders of the Cumberland
Valley, established one point; that the latter were
the subjects of a constitutional malady, which pro-
duced certain textural changes in the osaeoua tissue,
a malady which may or may not have been syphi-
lis, but which was incontestably like syphilis in its
pathologic lesions and may therefore have been lepra,
" the pathologic counterpart of syphilis and by some
writers regarded as essentially one with it."

I have myself attempted to show in an article en-
titled " Leprosy in America before the Advent of the
Spaniards and the Negroes," published in the Jour-
nal OF THE American Medical Association, Decem-
ber, 1894, that the disease, leprosy, did not exist;
among the ancient Aztecs. The Natchez are supposed
to be a connecting link between the mound- buildere
of the Mississippi Valley, and the ancient Aztecs.

62

If the Natchez had been lepers, the Aztecs would have
been lepers. Now, as I said in that article, and as Dr.
Brinton stated before, the word lepra, to the ancient
Spaniards, and the word teococoliztli to the ancient
Aztecs, meant the same disease, which undoubtedly
was syphilis. From which we may certainly draw
the conclusion that the pathologic lesions in the re-
mains found in the Cumberland Valley are more
likely to be attributable to syphilis than to leprosy.

Mr. Henry C. Mercer, Curator of the Section of
American and Prehistoric Archaeology, University
of Pennsylvania, who has just returned from an
exploration in Yucatan, says that he could not dis-
cover any proof of the assumed great antiquity of
the Mayas, or of their migrations ; he is inclined to
hold quite opposite views. " The interment vase,"
says he, "must be proved to be pre-Columbian, if it
is to be of any use in the argument, and this is not
an easy matter. lam not altogether," says he, " sat-
isfied with the syphilitic bones from Tennessee, but
am open to proof. I know how collectors * collect,'
and should want to be sure that Bandelier had dug
up the Peruvian vases himself, and studied the whole
interment. I found some crania on the eastern shore
of Maryland not long ago, in an ossuary, which Dr.
Harte, of the University, after examination says are
syphilitic, but the ossuary may not be pre-Colum*
bian. The description of these is already in MS. I
know the need of exact archseologic work in Central
and South America, where the first object has been
to discover startling facts and ^beautiful specimens,'
and trust you will be very careful in making use of
what has been sent up to us by enthusiastic collectors."

I may say here that these huacos potteries which
have been sent up by Mr. Bandelier are said, by com-
petent archaeologists, to be pre-Columbian. Certainly,
one of them, if dug out of a grave twelve feet deep,
which contained a Pachacamac pre-Columbian skull,
showing a syphilitic lesion, diseased frontal and pa-
rietal bones, must have some relation to the same

f

63

skull ; that is, represent the disease apparent in it.*
This cranial lesion is certainly due to syphilis. The
plates in Devergie's " Clinique de la Maladie Syphilit-
ique,^^ Paris, 1826, present caries and necrosis of the
frontal bone, of the nostrils and superior maxillaries,
following chronic syphilis ; exostosis and caries of the
frontal bone and of the cheek bone, and its surround-
ing parts ; caries of the frontal bone, nasal bones and
ethmoidal bones, developed under mercurial influ-
ence, and a process of healing; exfoliation of inter-
nal table of the frontal bone, followed by caries and
necrosis of that bone. These lesions are peculiarly
syphilitic. In the same atlas will be found plates
showing destruction of the nose and upper lip, strik-
ingly like the deformations on huacos pots ; scars of
carcinomatous and rodent ulcers (syphilitic) occupy-
ing the left wing of the nose, almost totally the upper
lip and left cheek, with caries of the cartilages of
the septum, and the wing of the nose; rodent ulcers
of the nose, lip, palate and of the throat with caries
of the bone ; irregular cicatrices of ulcers of the head ;
tuberculous and ulcerous cicatrices, with total loss
of nose ; tuberculous ulcer, loss of nose through the
progress of ulceration caused by syphilis, consecu-
tively developed after treatment by mercury; cica-
trices of ulcer of the head, and others of the face,
thought to be syphilitic, with caries of the upper jaw
and the nose.

These lesions are identical in appearance with the
lesions to be found in the huacos pottery. There is
but one loss of nose, and apparent loss of part of upper
lip, of a leper represented in Leloir's " Traits de la
Lepre,'' Paris, 1886. The title of this plate is : "Tuber-
culous lepra changed into tropho-neurosis, mixed
lepra; variety: systematized nervous tubercular
leprosy in a Norwegian." This is not like huacos pot-
tery, because there is typical leprous cicatrization
and contracture of the connecting link of flesh be-
tween the lip and the lost nose. It is not a loss of

* Note.— I haye written to Mr. Bandolier for the exact facts.

r

65

lip. Besides, there is the usual leprons stenoaia of
the oral aperture, and general facial atrophy. Theae
characteriatics do not appear in any of the huacos
Bpecimena. Moreover, ia the dry or atrophic form
of leprosy, the ooly form which these vases could
poBsibly represent, we should have crooked or muti-
lated &Qgeis, and deformity of eyelids which in these
vases never appear.

One thing more: to have the leprse bacillus from
a leprous country, say India or China, it is not only
necessary that the bacillus be t:ranaported in a human

body, but that the condition of life of the human
body itself should be transported also. This point
has been clearly explained by Hansen in his investi-
gations on the conditions of leprosy among the Nor-
wegians emigrating to Wisconain and Minnesota. He
found thiit while a number of lepers (of course not
known as such) had emigrated, in no case did he find
a second generation leper, or that a case of leprosy
had developed here from Norway not imported. He
aaaerts that the reason of it ia that th^ir habits
change, that their conditiona of life are not the same
SB those in Norway, and that therefore the conditions

66

necessary for the life and well-being of the bacillus
are absent.

CONCLUSIONS.

So far as I have investigated this subject, I con-
sider myself justified in saying: 1, syphilis and tu-
berculosis are pre-Columbian ; 2, that any deforma-
tion on American pottery would be more likely to
represent lupus and syphilis than leprosy; 3, the
pottery upon which the supposed leprous deforma-
tions appear, is beyond doubt pre-Columbian.

Note.— I may say here that I have examined many bones, in a disin-
tegrated condition to be sure, dug up at Llujon, Bolivia, five miles over
the Peruvian line, at a place called Tiahuanaco : also two skulls, at the
same place, which probably are not so old as the disintegrated bones.
These latter two skulls have the peculiarity of an open suture running
down from the coronal suture of the forehead to the root of the nose.
These skulls are, like the bones I mentioned, not only pre-Columbian,
but pre-Inca. In none of these U there any evidence of leprosy or even
of syphilis. What makes us look with some suspicion of leprosy at these
Tiahuanaco bones in Bolivia is the probable relationship between the
Micmacs of Nova Scotia and the. Tiahuanaco races of Bolivia. The Mic-
macs are supposed to have come north from the southwest, and to have
had relations with the Navajo and Apache Indians, and also with Peru,
Yucatan and Mexico. Whether the endemic leprosy of Nova Scotia, sup-
posed to have come with the Bretons, is at all connected with the Mic-
macs remains to be seen. «

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